1. Field of the Invention
The present invention relates to tracheal and gastro tubes inserted into the lungs or stomaches of patients.
More particularly, the present invention relates to tracheal and gastro pacifiers for use with tracheal and gastro tubes inserted into the lungs or stomaches of infants.
2. Description of the Prior Art
According to S. P. Ash, and J. P. Moss, at the department of Orthodontics, University College Dental School, in a paper published in the British Journal of Orthodontics, Vol. 14/1987, "Prolonged orotracheal intubation was shown to be associated with narrowing, deepening and some anterior elongation of the developing palate." Thirty babies were used in this test of less than 32 weeks of gestation. They further stated, "However, it has been suggested that various dental anomalies may be the result of prolonged endotracheal intubation."
Grahnen et al. (1974) suggested that the prevalence of enamel hypoplasia might be associated with respiratory distress at birth. Saunders et al. (1976) reported two cases of palatal groove formation and Duke et al. (1976) reported two cases of acquired clefts of the hard palate. More recently, Erenberg and Novac (1984), in a retrospective cross-sectional study, found a 47.6 percent incidence of palatal grooving in a group of pre-term infants subject to intubation. Even the use of `soft` endotracheal tubes does not lead to a reduction in the amount of palatal grooving (Molteni and Brumstead, 1986).
They went on to say, "It is common to find the babies sucking on the tube and this could result in a molding of the oral tissues and in particular the alveolus." They indicated that the evidence shows damage to the tooth buds.
"During reintubation, infants can suffer hypoxemia, bradycardia, and damage to the vocal cords (Thibeault, 1986)." "Death has occurred in some instances (Striker, Stool, and Downs, 1967) (Freeman, 1972)."
An article in Pediatric Radiology (1981) 10: 178-179 by A Delbert Bowen, M. D. reported on 18 cases of swallowed neonatal endotracheal tubes and one additional case of a 36 week gestation infant that swallowed the tube. Dr. Bowen mentioned in the article that fitting the tube with a collar or restraining device would be a precaution.
G. Ginoza, S. Cortez, and H. D. Modanlou, stated, "Possible consequences of the acquired groove include problems with dentition, speech, hearing, and middle ear disease." They further determined from their study that 87.5% of infants that were intubated for 15 days had palatial grooving.
R. A. Molteni and D. H. Bumstead, mentioned local trauma to the upper airways after prolonged intubation and included perforation, vocal cord edema, granuloma formation, subglottie cysts, unilateral or bilateral cord paralyaia, subglottic stenosis, and tracheitis.
A. Erenberg reported that the incidence of palatial groove was greatest in the neonate using the tube for 15 days or longer but was noted in one infant after only 12 hours of use.
An article by G. M. Angelos, D. R. Smith, R. Jorgenson, and E. A. Sweeney confirms the problem of future dental problems when using neonatal oral tracheal intubation. Also, another observation was made in this article that Sullivan (1982) describes that infants born after 26-36 weeks' gestation had neither sucking nor a coordinated swallowing reflex and had to be fed by sasogastric tubes. He suggested using orotracheal tubes for feeding if the tubes can be held securely.
According to R. C. Witzel, he stated, "while requiring oral endotracheal intubation, develop erosions of the upper alveolar ridge in precisely the position suggested by the report." He further stated, "I suggest, therefore that the lesion occurs as a result of drag on the endotracheal tube in this alveolar slot, which gives rise to pressure necrosis of the alveolar ridge and underlying tooth but. This acute lesion and its long-term sequelae could be prevented by avoiding contact with the alveolar ridges.
The adults and children beyond the pacifier stage are known to bite on the tracheal and gastro tubes, thus obstructing their functional use. Also, it is common to have accidental extubation with tape failure.
Numerous innovations for tracheal and gastro tubes have been provided in the prior art that are adapted to be used. Even though these innovations may be suitable for the specific individual purposes to which they address, they would not be suitable for the purposes of the present invention as heretofore described.